| Property Address: |
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| What type of property is this: |
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| Purchase Price: |
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| Loan Amount: |
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| How will you use this property: |
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| Which loan product are you interested in: |
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| Please let us know when you want to close the loan: |
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Borrower Information |
| Borrower First Name: | Co-Borrower First Name: |
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| Borrower Last Name: | Co-Borrower Last Name: |
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| Borrower Social Security #: | Co-Borrower Social Security #: |
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| Borrower Present Address | Co-Borrower Present Address |
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| City | City |
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| State | State |
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| Zip | Zip |
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| Home Phone: |
Co-Borrower Home Phone: |
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| Best time to call: |
best time to call: |
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| Borrower Age: | Co-Borrower Age: |
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| Marital Status: | Marital Status: |
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Employment Information |
| Borrower Name of Employer: | Co-Borrower Name of Employer: |
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| Borrower Address of Employer: | Co-Borrower Address of Employer: |
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| Is Borrower Self Employed | Is Co-Borrower Self Employed |
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| Borrower Position: | Co-Borrower Position: |
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| Co-borrower Business phone: |
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| Best time to call: |
Best time to call: |
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If employed in current
position for less than two years, please complete the following: |
| Borrower Name of Employer: | Co-Borrower Name of employer |
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| Borrower Address of Employer: | Co-Borrower Address of Employer: |
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| Is Borrower Self Employed | Is Co-Borrower Self Employed |
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| Borrower Position: | Co-Borrower Position: |
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| Borrower Business Phone: | Co-Borrower Business Phone: |
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| Best time to call: |
Best time to call: |
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Income Information |
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| Borrower Gross Monthly Income | Co-Borrower Gross monthly Income |
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| Borrower Overtime | Co=Borrower Overtime |
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| Borrower Dividends/interest | Co-Borrower Dividends/Interest |
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| Borrower Other Income | Co-borrower Other Income |
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| Net Rental Income | Net rental income co borrower> |
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| Monthly Housing Expense |
| Rent |
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| First Mortgage |
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| Other Financing |
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| hazard insurance |
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| Real Estate Tax |
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| Mortgage Insurance |
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| Homeowner Assn. Dues |
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| Other-income |
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Liabilities |
| Name of Company |
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| Address of Company |
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| Account Number |
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| Unpaid Balance |
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| Monthly Payment |
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| *** | *** |
| Name of Company |
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| Address of Company |
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| Account Number |
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| Upaid Balance |
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| Monthly Payment |
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| *** | *** |
| Name of Company |
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| Address of Company |
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| Account Number |
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| Upaid Balance |
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| Monthly payment |
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| *** | *** |
| Name of Company |
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| Account Number |
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| Unpaid Balance |
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| Monthly Payment |
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| *** | *** |
| Name of Company |
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| Address of Company |
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| Account Number |
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| Unpaid Balance |
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| Monthly Payment |
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| *** | *** | |
Asset |
| Name of Bank, S&L, or Credit Union |
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| Address of Bank, S&L, or Credit Union |
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| Account Number |
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| Balance |
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| *** | *** |
| Name of Bank, S&L, or Credit Union |
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| Address of Bank, S&L, or Credit Union |
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| Account Number |
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| Balance |
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| *** | *** |
| Name of Bank, S&L, or Credit Union |
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| Address of Bank, S&L, or Credit Union |
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| Account Number |
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| Balance |
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| *** | *** |
| Name of Bank, S&L, or Credit Union |
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| Address of Bank, S&L, or Credit Union |
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| Account Number |
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| Balance |
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| *** | *** |
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